Nursing Ethics Issue: Medical Assistance in Dying

This article discusses the importance of medical assistance in dying, evidence-based position as a nurse, ethical framework, and other positions in nursing ethics issue. It explores the benefits of medical assistance in dying for patients who are suffering from unbearable pain and the role of nurses in providing care. It also discusses the alternative option of palliative care and the ethical principles involved in medical assistance in dying.

Nursing Ethics Issue

Table of Contents
Introduction.................................................................................................................................................3
Main context................................................................................................................................................3
Importance of medical assistance in dying..............................................................................................3
Evidence-based position as a nurse..........................................................................................................4
Other position..........................................................................................................................................5
Ethical framework, model, theory, or ethical principles..........................................................................6
Conclusion...................................................................................................................................................7
References...................................................................................................................................................9

Introduction
Whenever a patient goes through unbearable suffering then the family members of the patients
have many decisions to make. The patient who is experiencing intolerable suffering due to a
permanent and serious medical condition can take medical assistance in dying. In this scenario,
doctors and nurses help the patient in ending their life (Beahan, 2019). This assistance can be
provided to legally eligible patients only. It is important to ensure that the service is being
provided in a safe manner. In order to protect it a system has been designed to support all people
who are making an informed decision. If an individual looking for medical assistance in dying
needs to consult with their local health authorities' care coordination service provider or doctor or
nurse practitioner. It occurs when a person requests an authorized doctor or nurse practitioner for
providing or administrating medication in order to end his or her life. Medical assistance has
brought historic change in Canadian society. It is difficult for nurses to choose from whether to
provide care to the patient who had chosen medical assistance in dying or refuse to participate in
MAiD, were explored. The impact of MAiD on nurses has three themes and eight storyline
clinical practices, view of the profession and personally. It has been found that most of the nurses
accepted maid as a part of their profession and their nursing practice, while a small number of
nurses has also expressed moral sorrow as they have assisted people in dying(Cusveller, 2013).
Main context
Importance of medical assistance in dying
Doctors and nurses are known for helping people and saving their lives. Involvement of others in
someone’s death can be an ethical burden for them that could itself be harmful. There is multiple
evidence from multiple countries that having this legislation suggest the burden of participating
in someone's death (Chochinov& Frazee, 2016). Medical assistance is dying is against the core
value and training of physicians and nurses as they are getting involved and causing the death of
other people. It is reasonable to expect that becoming part of the patient's death can bring
significant ethical fallout for nurses and physicians as people and a practitioner. This speaks to
the concern of the society that a person must not be condemned for feeling suicidal or for taking
his or her own life. But it doesn’t mean that it can be encouraged or facilitate, it might be

condemned if someone does so. It is helping people for getting rid of their pain and suffers.
Cancer is a terrible disease which has taken thousands of lives. Individuals having cancer suffer a
lot in their life and it becomes very difficult for them to bear the pain. In such situations, it could
be a good option for the patient of choosing to end his or life as doctors also know that he or she
cannot be recovered from his or her disease (Dewey, 2016). Patients of mental illness or
disability are considered to be more eligible for medical assistance in dying. Physically disabled
people face difficulties in their day to day life and sometimes they feel a burden to their family
members because they require someone's assistance for doing any physical activity or making
any physical movement.
Life becomes worse for them and sometimes few of them decide to give up. Again for these
patients, medical assistance in dying is the only option for getting rid of from their pain. Medical
assistance in dying could be helpful for those patients also who are barely living, not able to walk
and spending their lives on the bed from years hoping that one day he or she might become well.
Older people could be more benefited from MAiD as they are just to the end of their life. It is
more likely for them to suffer physically and mentally at this stage of life. Some of them do not
want to end their lives in the ICU instead chose to die with dignity (Fry, Veatch & Taylor, 2011).
As it is the last stage of their life, they often have multiple diseases, like chronic, heart disease,
stroke, cancer and diabetes which make them suffer. Medical assistance in dying often becomes
a controversial topic and it is also banned in many countries. It also considered being unethical
as it evolves others (doctor and nurses) for helping someone is dying. Despite this criticism,
MAiD could be an effective option for those people who have either lived their life or want relief
from his or her pain and suffering (Gibbons & Shafer, 2016). People are making these decisions
by themselves and if they choose to die then there must not be a problem.
Evidence-based position as a nurse
Being a nurse we always care for patients when they die, sometimes pain-free and peacefully.
Patients often suffer from symptoms that are hard to control. I have seen multiple cases of
struggling patients and their bad deaths and depressed family. The government has legalized
medical assistance in dying and this has deeply altered the approach of death and dying in
Canada. The initiate of government for helping people in dying seems to be opposing to my role
as a nurse. I had seen multiple patients of my own suffered and died without receiving dedicated

soothing care. It was painful and not acceptable. It was a powerful movement for me when I
watched a video of a microbiologist who had made a plea to the government for allowing him to
go for MAiD(Gibbons & Shafer, 2016). He was dying from brain stem cancer and was frustrated
with not being able to control his life. He was not even able to make decisions about himself.
Now, my point of view has changed and I consider this as an opportunity for being involved in a
very personal way. I decided to provide the care by myself. It was a natural evaluation of my
belief that the patient has the right to choose how they are going to die as they choose treatment
for their health conations. The story of patients can be considered as the most powerful factor in
this care. They really harden my judgment that this care is sympathetic and suitable. Patients
come with several diseases, like amyotrophic lateral sclerosis, and faced an inevitable decline to
helplessness, ultimately yielding to respiratory failure or other problems.
I often think about their courage and how they request for MAiD, right up to the movement of
their death. Many patients have described that they feel relief by knowing that they have control
over the end of their lives and they do not feel fear about the possible and unknown struggle to
them when they die. I have performed most of my cases of MAiD at patient’s home as I believe
it is most appropriate. The cooperation which I have received from the community nursing was
unusual and good. Families are extremely glad for this care as they are glad to see that their
loved one dies peacefully and feel a sense of release from their own suffering(Lafrance, 2018). I
have declined multiple cases of MAiD as the defined criteria were not meeting. The criteria
required the death to be reasonable and predictable, though there is no timeline has given. It is
challenging for me to consider people with an unbearable condition that are not predictable fatal.
The current criteria also exclude children who have been suffering from mental illness and
patients developing dementia who would like to pre-qualified for medical assistance in dying
when they are not living meaningfully any longer (Schultz, 2009). It has been found that nurses
are often become supportive of MAiD, usually actively. The hands-on perspective of nurses is
more convincing than the physicians as they spend less time with patients.
Other position
The alternative option of medical assistance in dying could be palliative care. Patients may
choose the other side of MAiD which is not losing hope and fighting till the end. Palliative care
focuses on providing relief to the patients who are suffering from some serious illness and

having a goal of improving the quality of life of the patients and their family(Larm, 2019). It is
being provided by a specially trained team of doctors and nurses who work with each other for
providing an extra layer of support and care to the patient. The team of palliative care is
specialized in treating those people who are suffering from the stress of serious illness and
symptoms like, congestive heart failure, Alzheimer’, cancer, kidney disease and many more.
Palliative care treats depression, difficulty sleeping, shortness of breath, pain, constipation,
anxiety, and loss of appetite and many more symptoms that may cause distress (Grice &
Meehan, 2016). The main reason for choosing MAiD is stress and the team of palliative care
helps people in gaining their strength to carry on with their daily life. In other words, it helps in
improving the quality of life.
The team of palliative care spends a lot of time with their patients talking and listing. They make
sure that patients are able to understand all of the options of the treatment and choices
(Savulescu&Schuklenk, 2016). They use the patient's personal goals in their treatment and help
them to match their goals as their treatment option. They also make sure that all of the doctors
are coordinating with each other and understand and know what the patient actually want. This
might help patients I have more control over their care and can improve their quality of life. The
team palliative care is totally different from the team of MAiD as they work together with the
family of the patients and their other doctors. They focus on providing an extra layer of support
when the patent need to most. In order to treat a patient’s stress, and symptoms and supporting
him or his family, the team of palliative care prefers communicating with all of the doctors of the
patients so that everyone could be on the same page (Timby, 2009). Palliative care can be
considered as the other side of MAiD as it helps patients in improving their strength and provide
relief from pain and stress. Both of the care has same goal providing relief to the patients
however, one takes the patient's life and the other gives hope and strength to carry on with life.
Ethical framework, model, theory, or ethical principles
There is an aspect that is very important but rarely discussed. How it could be ethical for an
individual to ask another person for killing him or her or to become a part of that individual’s
death. This is related to ethics. MAiD is considering being a request to a physician or nurse
practitioner for participating in suicide or euthanasia. Many scholars have defined that if the
death of a person is reasonably foreseeable and the life of the individual is full of suffer then it is

legal for asking someone’s assistance(Tschudin, 2013). MAiD is helping people from getting rid
of their pain and suffering and as a nurse, I believe there is nothing wrong with it as far as they
are eligible enough to take this decision. My motives are to provide this care to all those patients
who actually require medical assistance in dying. I am a nurse and being a nurse it is my duty to
take care of my patients and help them in getting relief from their pain and suffering. I am
motivated after seeing the reactions of the family members of the patients. Patients are suffering
from years. They are neither living nor dying, they are just alive and breathing. It is very hard for
family members to watch their loved one suffering like this. They feel glad when they see they're
loved in peace. I know it is hard to put myself in the situation of my patients, but I know if I
were in their place I might have chosen the same option. There are other options like palliative
care that also help people in getting relief from their stress and pain though, it cannot work with
every patient as every patient are dealing with a different kind of pain and disease. A patient who
has been spending his life on the bed for years and not even can move his body. He requires
assistance for every single physical activity. It is more likely that he would prefer dying as there
is no hope for him(Wootton, 2017).
Conclusion
Being a nurse we always care for patients when they die through medical assistance; we make
sure that it must not be painful. Patients often suffer from symptoms that are hard to control. I
have seen multiple cases of struggling patients and their deaths and depressed family. Medical
assistance in dying could be helpful for those patients also who are barely living, not able to walk
and spending their lives on the bed from years hoping that one day he or she might become well.
Older people could be more benefited from MAiD as they are just to the end of their life. It is
more likely for them to suffer physically and mentally at this stage of life. People are making
these decisions by themselves and if they choose to die then there must not be a problem. There
is also a criterion set by the government of Canada and if an individual meeting that criteria then
it should not be a problem. MAiD is helping people from getting rid of their pain and suffering
and as a nurse, I believe there is nothing wrong with it as far as they are eligible enough to take
this decision.

References
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